Abstract Details

Title A Cognitive Behavioral Therapy Pilot Program Delivered via Telemedicine Is Associated with Reduced Headache Disability in Patients with Migraine

Topic Headache

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 15-002

Background CBT is an effective treatment for migraine. Reduced headache frequency and severity, and headache-related disability have been identified as goals for behavioral interventions by the US Headache Consortium.

Objective To assess the change in headache frequency, severity, and disability for patients with migraine participating in an 8-week telemedicine cognitive behavioral therapy (CBT) pilot.

Design/Methods Fifty-nine patients receiving care from the novel Cove migraine telemedicine platform were invited to participate in an 8-week CBT pilot. The pilot consisted of 8 audio and written modules. Patients who opted-in to the pilot continued to receive care via the telemedicine platform, which provides asynchronous consultation, outcomes tracking, and e-pharmacy. Pre- and post-intervention data were analyzed.

Results

Among the 59 patients invited, 53 (90%) subjects enrolled in the first module, expressing interest in CBT as a treatment option. There were 25 subjects (47% of enrolled subjects) who completed all 8 modules; data from 21 subjects who completed both intake and post-pilot questionnaires were analyzed. The average age of participants was 38 years and 100% were female. Prior to the pilot, subjects had been treated via the migraine telemedicine platform for an average of 12 months; 81% of subjects had been prescribed acute care medications and 62% preventives.

At the time of enrollment, subjects had 5.8 mean monthly headache days, a mean headache severity of 6.5 (on a 10-point pain scale), and a mean Migraine Disability Assessment score (MIDAS) of 32.4.

At the completion of the 8-week pilot, subjects had a mean 1.3 day reduction in monthly headache frequency, a 1.1 point reduction on the pain scale, and a 13% reduction in MIDAS score.

Conclusions The migraine patients in this telemedicine-based CBT pilot showed improved clinical outcomes over the pilot period, including reduction in headache frequency, severity, and headache-related disability. These pilot data warrant further investigation in large sample RCTs.

Authors/Disclosures
Sara C. Crystal, MD (NY Headache Center) PRESENTER	Dr. Crystal has received personal compensation for serving as an employee of Thirty Madison. Dr. Crystal has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biohaven. Dr. Crystal has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan.
Alexander Mauskop, MD, FAAN (New York Headache Center)	Dr. Mauskop has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Allergan. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eli Lily. Dr. Mauskop has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Lundbeck. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biohaven. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amgen. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan.
Alan M. Rapoport, MD, FAAN	Dr. Rapoport has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AbbVie, Amgen, Biohaven, Cala Health, Satsuma, Teva Pharmaceutical Industries, Theranica, Xoc and Zosano. Dr. Rapoport has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for AbbVie, Amgen, Biohaven, Lundbeck and Teva Pharmaceutical Industries. Dr. Rapoport has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology Reviews.
Robert Cowan, MD, FAAN (Stanford Neurosciences Health Center)	Dr. Cowan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lundbeck. Dr. Cowan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. Dr. Cowan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbvie. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for lundbeck. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for biohavenn. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbviie. Dr. Cowan has stock in Percept. Dr. Cowan has received intellectual property interests from a discovery or technology relating to health care. Dr. Cowan has received intellectual property interests from a discovery or technology relating to health care. Dr. Cowan has received publishing royalties from a publication relating to health care.
	No disclosure on file
	No disclosure on file
Adam B. Cohen, MD (Massachusetts General Hospital)	Dr. Cohen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Thirty Madison. Dr. Cohen has received stock or an ownership interest from Thirty Madison.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file